Concurrent HCV, opioid agonist treatment improves quality of life for injection drug users
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People who inject drugs experienced sustained increases in health-related quality of life when they were successfully treated for hepatitis C during opioid agonist treatment, according to a study published in Clinical Infectious Diseases.
Assessing how HCV treatment impacts health-related quality of life for people who inject drugs (PWID) “is necessary to better understand the relationship between curing HCV and improving patient-centered health outcomes for a population whose stigmatization often creates barriers to accessing treatment,” said Alain Litwin, MD, a professor at Clemson University and executive director of the Prisma Health Addiction Research Center.
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“There is little previous research investigating the relationship between HCV treatment with direct-acting antiviral agents and health-related quality of life among PWID,” Litwin told Healio.
Litwin and colleagues studied 141 PWID who achieved SVR following HCV treatment at three opioid agonist treatment (OAT) clinics in Bronx, New York. According to the study, they assessed five health dimensions mobility, self-care, usual activities, pain/discomfort and anxiety/depression producing an index of health-related quality of life (HRQOL) ranging from 0 to 1 referred to as EQ-5D-3L. These were measures at baseline, 4 weeks, 8 weeks and 12 weeks during treatment and 12 and 24 weeks after treatment.
Overall, the study demonstrated a mean EQ-5D-3L at baseline of 0.66. At this time, more than half of the study population reported no baseline problems with self-care (85.1%), usual activities (56%) or mobility (52.5%), and at least two-thirds reported problems with pain/discomfort (78%) and anxiety/depression (66%), with 22% and 21.3% reporting extreme problems for pain/discomfort and anxiety/depression, respectively, Litwin and colleague reported.
At 24 weeks after treatment, the study demonstrated that the proportion of participants reporting pain/discomfort and anxiety/depression decreased by 25.7% and 24%, respectively. According to the researchers, this means the mean EQ-5D-3L significantly improved during treatment and was sustained at 0.77 12-weeks after SVR following treatment completion.
Mirinda Ann Gormley, PhD, MSPH, a postdoctoral fellow at the Clemson University College of Behavioral, Social and Health Sciences, said that although the increases were sustained following HCV treatment, the overall HRQOL was still lower than the HRQOL of the general U.S. population.
“Our results show that successful HCV treatment can increase the health-related quality of life of PWID on OAT, which should encourage future efforts to implement treatment for HCV during OAT,” Gormley and Litwin told Healio. “Additionally, although health-related quality of life increased following successful HCV treatment, these results show that additional actions may be necessary to raise the health-related quality of life of this population.”
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